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Final Rate Update for AIDS Medi-Cal Waiver Program

June 28, 2018

Effective retroactively for dates of service on or after July 1, 2017, the AIDS Medi-Cal Waiver Program (MCWP) has updated reimbursement rates for several HCPCS and CPT-4 codes. The updated rates are as follows:

CPT-4 or
HCPCS Code
Description Maximum Rate
90837 Psychotherapy, 60 minutes with patient $51.00
per hour
90846 Family psychotherapy (without the patient present), 50 minutes 51.00
per hour
90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes 51.00
per hour
G0156 Services of home health/hospice aide in home health or hospice settings, each 15 minutes 5.01
per 15 minutes
G0299 Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes 10.15
per 15 minutes
G0300 Direct skilled nursing services of a license practical nurse (LPN) in the home health or hospice setting, each 15 minutes 7.36
per 15 minutes
S5130 Homemaker service, nos; per 15 minutes 3.72
per 15 minutes
S9470 Nutritional counseling, dietitian visit 33.48
per hour
T2003 Non-emergency transportation; encounter/trip 40.00
per client per month
T2022 Case management, per month 229.17
per client per month
T2025 Waiver services; not otherwise specified (nos) 170.28
per client per month

An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. No action is required of providers. These rates are exclusive for AIDS MCWP.

Updated manual pages reflecting this change will be released in a future Medi-Cal Update.